Provider Demographics
NPI:1205835139
Name:RUTHERFORD, KATHERINE (WHCNP)
Entity Type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:
Last Name:RUTHERFORD
Suffix:
Gender:F
Credentials:WHCNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 RAMSEY AVE
Mailing Address - Street 2:
Mailing Address - City:GRANTS PASS
Mailing Address - State:OR
Mailing Address - Zip Code:97527-5788
Mailing Address - Country:US
Mailing Address - Phone:541-479-8363
Mailing Address - Fax:541-476-2841
Practice Address - Street 1:700 RAMSEY AVE
Practice Address - Street 2:
Practice Address - City:GRANTS PASS
Practice Address - State:OR
Practice Address - Zip Code:97527-5786
Practice Address - Country:US
Practice Address - Phone:541-479-8363
Practice Address - Fax:541-476-2841
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR079038198N7363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR053616Medicaid
OR559288Medicare UPIN
OR053616Medicaid